[Question #12176] Possible Syphilis Encounter - MSM
9 months ago
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Hi Doc,
Background:
Sexual Encounter took place with an anonymous male on 10/17. NO oral or anal sex took place. Mutual masterbation took place and penis to penis contact happened (which I've now learned is frotting). From what I remember, I don't recall seeing (or feeling) any sores or outbreaks.
10/17 (6 hours after this encounter) - Although considered safer sex, I learned that this encounter had a risk of syphilis. I took DoxyPEP, 2 100mg of Doxycycline to combat this risk.
10/28 (11 days post encounter) - I took a blood test which came back negative for syphilis (which I know is too early to test).
10/29 (12 days post encounter) - I took a blood test again, and received an Penicillin injection (Bicillin 2.4 million units).
Do you think these precautions are enough to warrant me risk free from contracting syphilis from this exposure?
I am also in a relationship, when do you think I can resume sex safely with her?
Would you still recommend me testing at 6 weeks and 3 months from the exposure date?
Is it possible to still have Syphilis from this encounter after the precautions that I took?
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H. Hunter Handsfield, MD
9 months ago
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Welcome to the forum. Thank you for your confidence in our services.
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You are more concerned and worried about these events than warranted by the scientific realities. The exposure you describe was very low risk for syphilis. Is it impossible syphilis could be transmitted? No. But how likely was it? Under one chance in millions. I would have recommended against doxycycline prophylaxis (which is only recommended following unprotected anal sex between men at high risk), and against the penicillin treatment you received. The Bicillin was even less necessary on account of the doxycycline, which was by itself nearly 100% protection against syphilis if you had been exposed.
That said, the antibiotics probably did you little harm; they were just unnecessary. But my replies to your specific questions are based on both the low risk of the event and the 100% protection against syphilis you have experienced from them.
"Do you think these precautions are enough to warrant me risk free from contracting syphilis from this exposure?" Yes. "Is it still possible to have syphilis...?" No. (These are the same question in different words.)
"... when do you think I can resume sex safely with [my female partner]? You never had to stop and certainly can safely resume sex with her now.
"Would you still recommend me testing at 6 weeks and 3 months from the exposure date?" There is no point in further syphilis testing. If you would like reassurance against HIV, you could have an AgAb (4th generation) blood test 6 weeks after the event, but testing beyond that is not needed. Of course you are free to be tested for either or both if you need the negative results for reassurance. But not because of actual risk.
So all is well. Feel free to test later for syphilis and/or HIV, as you wish. If you do so, you can definitely expect negative results. If somehow I were in your situation, I would be moving on without the least concern.
I hope these comments are helpful. Let me know if anything isn't clear.
HHH, MD
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